Overdose Reversal Drug Naloxone (Narcan) Surges in Price

The epidemic of overdose deaths related to prescription painkillers and heroin in the United States is now routinely in the news. Public awareness of the issue has reached an all time high. While the White House announces initiatives to combat the problem, Saturday Night Live makes late night mockery of it. All this to say that America’s struggle with opioid addiction is now mainstream and pharmaceutical companies, some believe, are using it to make a profit.

Naloxone, also known as Narcan, is a fast acting, easy to administer medication that reverses the effects of an opioid overdose. It is nontoxic and non-addictive. The drug’s ability to block opioid receptors in the brain that interact with prescription painkillers and heroin is a key tool in reducing the number of overdose deaths – 28,647 in 2014 alone – caused by opioid abuse.

A decade ago the going price for naloxone, which has proven to drastically reduce overdose deaths, was $1 a dose. With a shift in treating drug overdoses as a medical problem instead of a criminal one, state and local governments across the country began outfitting their officers and first responders with naloxone (Narcan). That’s when prices surged to as much as $40 a dose.

How Much Has Naloxone Increased in Price Across the Country?

Georgia police officials report the price going from $22 to $40

In New York, health department officials reported a 50 percent increase in the nasally administered form of the drug

Baltimore saw an increase from $20 to $40 in just a five month span

From December to February in Plymouth, Mass., the price rose from $18.50 to $44.54

Director of the advocacy group VOCAL-New York, Matt Curtis, told The New York Times, “…these big government programs come in and now all of a sudden we’re seeing a big price spike. The Timing is pretty noticeable.”

Amphastar Pharmaceuticals manufactures the most widely used form of naloxone. First responders generally prefer an intranasal administration, but the high-concentration dose is also injectable. Officials at Amphastar claim increases in raw materials, labor and manufacturing are responsible for the rising costs. Critics are not buying that excuse.

“[Amphastar has] no competition,” Daniel Raymond, policy director for the Harm Reduction Coalition, said in an interview with National Public Radio. “They can set whatever price they want, and year ago, they decided to almost double that price. It’s hitting programs and health departments and first responders across the country really hard.”

Despite the Food and Drug Administration’s (FDA) failure, so far, to approve the intranasal use of naloxone, both CVS and Walgreens pharmacies offer the prescription drug over-the-counter in a number of states.

According to the Centers for Disease Control and Prevention (CDC), from 1996 to 2014, naloxone was used by people with no medical expertise to reverse 26,463 opioid overdoses.

There are critic grumblings that naloxone offers opioid addicts a quick “save shot” before they go back out and abuse drugs again. Yet, the realities of a “save shot” are not at all pleasant. Though an overdose is reversed if naloxone is given quickly enough, the victim often goes into immediate and painful opioid withdrawal, making it unlikely that the victim will hop up and head out for more drugs.

There are a few bright spots in the naloxone saga. Several states, including California, have struck rebate deals with Amphastar Pharmaceuticals. Under the agreement, the company will offer $6 back on any order from Amphastar or a third-party business. Moreover, if the price continues to increase so will the rebate. While it is not a deep price cut, it will make a bit more affordable for hospitals, health departments and law enforcement agencies buying the drug in bulk.

Advocates of wider naloxone (Narcan) availability are hopeful that demand for the drug will drive competitors into the market and the price will fall by the end of the year.

Naloxone is certainly not a solution to the opioid epidemic, but when lives are saved, there is a greater opportunity for treatment and rehabilitation at a time when many around the country need it the most.